schizophrenia: symptoms and features

Question 1

you are definitely diagnosed with SZ if you experience….?

Answer 1

delusions
hallucinations
disorganised speech/thought
AND , experience a month of active symptoms and experienced disturbance to everyday life for at least 6 months

Question 2

what are the 4 key symptoms?

Answer 2

thought insertion
hallucinations
delusions
disordered thinking

Question 3

what is thought insertion?

Answer 3

when a person doesn’t believe their thoughts belong to them and are from an external force.
experience blurring between self and others > lead to belief thoughts and feelings can pass from one person to another

Question 4

what are hallucinations?

Answer 4

involuntary and clear experiences that appear to be real but are created in the mind.
can be visual, olfactory and auditory (most common)
often voices clearly distinct from ones own

Question 5

what are delusions?

Answer 5

fixed beliefs that are not changeable in the light of conflicting evidence
EG. movements monitored by police or bizarre- aliens after you

Question 6

what is disordered thinking?

Answer 6

jumbled and unrelated thoughts leading to incoherent speech

Question 7

features of SZ?

Answer 7

-onset earlier in males (early 20’s) than females (late)
-males poorer prognosis than females and hard to predict
minority recover completely and most show chronic impairment
-positive symptoms reduce, negative remain

Question 8

can SZ be reliably diagnosed?

Answer 8

-high degree of consistency with diagnosis with DSM and ICD
DSM kappa values- 0.45 (Reigers) whilst others found 0.85
only 4% lacked confidence with their diagnosis of SZ with ICD
IMPORTANT- suggests descriptors of SZ are detailed enough to allow clinicians to distinguish this condition form others

Question 9

BUT…?

Answer 9

diagnosing SZ is not easy as it shares symptoms with other disorders
EG. hallucinations > depression, PTSD and drug withdrawal

Question 10

another issue with diagnosis?

Answer 10

-diagnosis can be difficult if individual is from different cultural background to clinician
EG. Rastafarians use neologisms which are often a play on English words (overstand> understand, downpress>opress)
if clinician is unaware they may see it as sign of disorganised thinking
SO, accurate diagnosis requires awareness to cultural and linguistic approaches